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If you’re bolting right after sex, you could be ruining your sex life for you and your partner.

Take it from me. One of my first sexual experiences as a young adult was with a guy we’ll call Jay. He was older, more experienced, very good-looking and hence, seemed slightly intimidating to me.

We had great chemistry and spent an entire summer making out in the backseat of his mom’s car. However, everything shifted the first time we had sex and he wouldn’t even make eye-contact. Before I could roll into an upright position, Jay had managed to jump out of the bed and get dressed. He was out the door within minutes. Years later, my therapist would explain to me that Jay likely had “intimacy issues.” But at the time, the experience left me feeling completely naked – literally and figuratively.

I’ve since come to realize that what comes after sex is almost as important as the act itself. Even if a relationship is casual, being able to cuddle, connect and check in with your partner following sex is not only really enjoyable, it also has the potential to make or break the experience.

Therefore, I wasn’t surprised when Trojan and The Sex Information and Education Council of Canada surveyed midlife Canadians and found that after-sex behaviour contributes to overall sexual satisfaction.

According to the study, women who reported 6 to 10 minutes of affectionate behaviour after sex were much more likely to rate their intercourse experience as very pleasurable compared to women who reported 0 to 5 minutes. Researchers say it all comes down to what they’ve dubbed “the 6-minute rule.”

So, how exactly does it work?

“When couples are being sexual, it’s an opportunity for intimacy and connection. The 6-minute rule refers to cuddling and intimacy that occurs AFTER sex (the counterpoint to foreplay),” explains Robin Milhausen, a sexuality and relationship researcher and associate professor at the University of Guelph. Biologically speaking she says, “during sex, and after orgasm, men and women experience a boost in the hormone oxytocin. This hormone has been associated with feelings of connection, affection, and bonding. So we are primed after sex, in part because of oxytocin, to bond with our partners, especially if we spend a few minutes being affectionate.”

As Milhausen points out, “sex makes us vulnerable – we are physically (and emotionally!) naked. As a result, what happens during a sexual encounter can make us feel wonderful – loved, beautiful, sexy – but it can also make us feel worse – self–conscious and disconnected. So those minutes after sex are crucially important to creating a positive experience.”

What’s exciting about the 6-minute rule is that it’s an “intervention” that most couples can implement with very little difficulty. It’s literally as easy as not rolling over and going to sleep immediately after sex. “Cuddle! Talk about the high points of the encounter,” says Milhausen. For example, you can let your partner know, “I really loved when you did ____” or “that was so hot when______ happened.”

These six-minutes post-sex are a great opportunity to experience a good sexual encounter again.

“ Being kind after sex can help your partner feel valued and appreciated. And it’s the perfect time to communicate that message.”

Clearly anxiety can be an obstacle to a healthy sex life and needs to be talked about.

You’re stressed so you clench. When you clench, it cramps. It’s a cycle that starts in the mind and finds its way down into the body. And I’m not talking about your jaw, I’m talking about your genitals.

Anxiety presents itself in many ways, but one of its more clandestine manifestations takes place below the belt. For men, that can lead to erectile dysfunction, an ailment we’re all familiar with thanks to late-night ads. Far fewer of us can list the effects anxiety has on the female sexual response cycle.

After researching 5,865 adolescents and adults ages 14 to 94, researchers at the National Survey of Sexual Health and Behavior (NSSHB) found that upwards of 30 percent of women report pain during vaginal intercourse. The most common approach to the problem was to “do nothing.”

As Andrew Heartman, a certified sex surrogate based in California, has reminded us,“[Women] can engage in sexual activity, but not really be present, and not really enjoy it… they can perform sufficiently to have their partner be satisfied.”

Sometimes, it’s worse than just a lack of enjoyment.

“I would say one of the main reasons women come in to see a sex therapist is because they have painful sex,” says Houston-based sex therapist Mary Jo Rapini. “When you talk to them further, you start understanding it’s their anxiety.”

She explained that some women are so hard hit with anxiety during sex that their vaginal muscles tighten up to the point that penetration becomes impossible. “When they do try to have intercourse, they can’t,” she says.

Rapini treated one woman who had gone 12 years without having sex because it was too painful. Even on her wedding night, she was unable to consummate the marriage. In other extreme cases she’s seen women unable to undergo a procedure as simple as a pap smear. “They can’t get the speculum in,” she says. “It’s so tight.”

Unfortunately, stigmas surrounding sex, specifically sexual dysfunction, run deep, and most people shy away from addressing the issues head on. “There’s an element of shame, with anxiety and depression. We’re used to seeing it as a weakness or proof there’s something wrong with you,” says Rapini.

As opposed to the platter of pills available to help enhance male sexual performance, the FDA has approved just one pill to treat sexual dysfunction in women. It’s called flibanerin, and it was originally marketed as an antidepressant.

But just because it’s an uncomfortable topic to bring up doesn’t mean it’s uncommon. As Rapini explains, “Anxiety is growing in the population and it’s incredible… Our brains have trouble just throwing stuff out.” According to Rapini, it’s not uncommon for this kind of anxiety-induced vaginal tightening to occur in women the week before their periods. Many women are also affected during the pre-menopausal period. “Your hormones are all over the place,” she says.

But not all instances fit neatly into a timetable. Rapini explains that women can be especially sensitive to situational factors relating to sex. Women who aren’t comfortable with their partners, women in bad relationships, even women turned off by something said during sex can find themselves closing up at a moment’s notice. “As a sex therapist, my job is more finding tools for them to help them relax,” says Rapini.

Within clinical circles, the condition is known as vaginismus, which the American Congress of Obstetricians and Gynecologists defines as a “reflex contraction (tightening) of the muscles at the opening of the vagina.” Because the condition has been linked to stress and anxiety, therapy is recommended. Often, vaginal dilators are also employed. As WebMD notes, “The approach is called progressive desensitization, and the idea is to get comfortable with insertion.” For women who experience more mild symptoms, other approaches may apply such as antidepressants, warm baths, breathing exercises, and heating pads.

Of course, when it comes to arousal issues with women, you’ve also got to give a nod to lubrication. Vaginal dryness is a big issue, and according to Rapini, it often works alongside anxiety to sabotage women’s pleasure. “For an orgasm to happen, first of all, the woman has to create the scene or the excitement in her mind. You can’t do that if your mind is focused or taken over by anxiety… and especially if you’re not using lubricant,” she says.

Experiencing pain during sex may not be the easiest thing to admit to, but Rapini says it’s not as unusual as one would think. “First of all, this is not abnormal. It affects a large part of the population.” Reports hold that women are twice as likely to experience anxiety as men. But the first step to securing sexual satisfaction in women takes place in the mind. “There’s a rhythm to recovery,” says Rapini. “That rhythm starts by slowing down.”

From fully customizable vibrators to bioelectronic headsets, smart sex toys are on the way up. But does personal pleasure necessarily make for better health?

Pleasure is personal, mostly because it has to be, and not least because female scientists continue to face grinding discrimination regardless of their area of research. And when it comes to sexual health, breakthroughs are few and far between: in spite of increasing documentation of associated health risks, birth control hasn’t really been reformulated since the 60s, and last year’s much-anticipated release of Addyi, a pill meant to fix female sexual dysfunction, only worked for ten percent of the women who tried it.

It’s clear that sexual emancipation has not yet been freed from the bedroom. In spite of its roots in scientific misogyny—the vibrator was developed in the 19th century to cure women of hysteria, after all—a swathe of new devices have people looking hopefully to sex tech (or sextech, as it is also known) as the answer to systemic gaps in sexual health. History, it seems, is coming full circle; where the 1960s saw the vibrator de-medicalized and uncoupled from science, today’s consumer market is beginning to see pleasure and health unified in the pursuit of wellness. Yet what we call “sex tech” is tied more to the lucrative sex toy industry—worth $15 billion this year—than it is to scientific institutions, with much of its promise linked to idea that personal pleasure makes for better health.

These days, more people than ever understand that a woman’s ability to understand what turns her on and why is a crucial step in developing a healthy perspective on her sexual life. So it makes sense that we’re seeking out masturbatory experiences that are more tailored than your average stand-in phallus. It’s the driving force behind the popularity of devices like Crescendo, the first-ever fully customizable vibrator, which raised £1.6 million in funding to date and shipped out over 1,000 pre-orders after a successful crowdfunding round.

Designed to cater to the inherent complexities of female arousal, the vibrator can be finely customized, equipped with six motors and the ability to be bent into any favorable shape. An accompanying app allows users to control each motor individually; it remembers favorite behaviors, provides pre-set vibration patterns, and responds to mood-setting music.

“We were inspired by the concept of tech designed for the human, rather than the human having to adapt their behaviour to tech,” says Stephanie Alys, the co-founder of Crescendo creators Mysteryvibe. “Human beings aren’t just unique in terms of our size and how we’re put together genetically, but also in terms of what we like. What turns us on can be different from what turns another person on.”

Mysteryvibe’s flagship product is the Crescendo, a customizable sex toy.

But in spite of the life-improving promises of consumer sex tech, the reality is that official, peer-reviewed studies remain crucial to reforming policy and education. Founded by Dr. Nicole Prause, Liberos Center is one of the few sex-centric research institutions in the United States. Much of its work investigates the relationship between psychology, physiology, and sex, with an emphasis on the hard data that is often lacking in sex tech.

Liberos presses on in a particularly antagonistic climate; the American government is famously skittish about sexual content. Sexual material is banned from government-funded computers, says Prause, making it difficult for researchers to, say, screen porn to test subjects as part of a study on arousal. She adds that congressional bodies actively seek to pull funding from research that addresses the topic head-on—four recent studies that had already been awarded funding were re-opened for assessment because of their sexual content.

“People report having certain types of experiences all the time,” says Prause. “But they’re often poor observers of their own behaviour, and don’t see anyone’s behaviour but their own. They don’t really have that external perspective, which is why I think it’s important to take both a psychological and laboratory approach. For example, in science, people haven’t been verifying that orgasm actually occurs. So we’ve been developing an objective way of measuring that, and of measuring the effects of clitoral stimulation—on how to best capture the contractions that occur through the orgasm.”

Liberos is also investigating the effect of transcranial magnetic stimulation (TMS) and direct current stimulation (tDCS) on sexual responsiveness. Both are non-invasive treatments, meaning anyone seeking a cure for low libido may not require anything more than the use of a headset. TMS holds potential for long-term changes to a person’s sex drive; the technique, which uses a magnetic field generator to produce small electrical currents in the brain, has already been used to treat neuropathic pain and otherwise stubborn cases of major depressive disorder. DCS, on the other hand, uses a headset to deliver a low-intensity electrical charge, stimulating the brain areas where activity spikes at the sight, or touch, of a turn-on.

If using the brain’s electrical signals to control the rest of the body sounds like a dystopian fantasy, the reality is that these medical treatments aren’t far off. Bioelectronic firms are now backed by the likes of Glaxosmithkline and Alphabet, Google’s parent company, and similar applications have already been established for hypertension and sleep apnea, while chronic conditions like asthma, diabetes, and arthritis are targeted for future development.

According to Dr. Karen E. Adams, clinical professor of OBGYN at Oregon Health and Science University, anywhere from 40 to 50 percent of women experience varying degrees of sexual dysfunction. Medication that targets neurotransmitters, like the SSRIs used to treat depression and anxiety, can fluctuate in efficacy depending on the unique makeup of the person using it.

Combined with the trickiness of locking down the nebulousness of desire (and lack thereof), it’s no wonder that Addyi, a failed antidepressant pursued because of its unexpected effect on serotonin levels in female mice, was a flop. Non-sex-specific studies have shown that electrical stimulation can be more adaptive to the brain’s constantly-shifting landscape than medication that interacts with its chemistry. For the 90 percent of women who found Addyi to be a sore disappointment, bioelectronic treatments could soon offer an alternative solution to low sexual responsivity.

“By giving women information about their bodies that they can decide what to do with, we’re enabling more female empowerment,” says Prause. “And by allowing women to decide which aspects of sex they want to be more responsive to, we’re giving people more control, and not with charlatan claims. We actually have good scientific reasons that we think are going to work, that are going to make a difference.”

Yet the field’s burgeoning successes are only as good as the social environment they take hold in. Sociopolitical hurdles notwithstanding, money remains a significant roadblock for developers, as the controversial nature of sex research has many investors shying away from backing new projects in spite of consumer interest. Whether they’re seeking government funding or VC investments, sex start-ups and labs alike are often forced to turn to crowdfunding to raise money for development.

“It’s pretty unsurprising that heavily female-oriented tech products do so well on crowdfunding sites; these are solutions to problems faced by half of the population, that are overlooked by a male-dominated industry where male entrepreneurs are 86 percent more likely to be VC funded than women,” says Katy Young, behavioral analyst at research firm Canvas8. “But the audience is clearly there—Livia, a device which targets nerves in order to stop period pains, raised over $1 million on Indiegogo.”

Outdated sex ed programs, which emphasize procreation and normalize straight male sexuality without addressing female sexual development, are ground zero for unhealthy social perspectives on sex. Acknowledging that change can’t just come from devices alone, New York’s Unbound, a luxury sex toy subscription service, is teaming up with “campus sexpert” app Tabù to bring both sex education and affordable masturbation tools to colleges across the country.

“There’s a national discussion right now surrounding consent, which is 100 percent needed and super important,” says Polly Rodriguez, CEO and co-founder of Unbound. “But for women to be able to engage in sex and address consent as equals, they need to learn about female pleasure—they should understand their own bodies so that when they are engaging in sexual activities with someone else, they know what feels good to them, they know how to communicate that, and they don’t feel uncomfortable about it.”

It’s tempting to buy into the idea of tech as freeing: that the increased presence of smart devices in our lives will help us form healthier habits and a better understanding of our ourselves, or that the availability of medically-approved tech will be a panacea in the intricately fraught landscape of female sexual dysfunction—which is as socially determined as it is biological, and as cultural as it is psychological.

But sex tech is still far from being paradigm-shifting. Its success will be dependent not only on consumer dollars but on government policies and public attitudes; at a level of engagement this intimate, tech is only any good if people feel free to use it.

Casual sex, hookups or one-night stands: whatever you call it, more than half of us will have sex with someone we barely know or don’t expect to date in the future. We’re most likely to do this at university, where up to 80% of undergraduates have hookups. Sex within relationships is said to improve cardiovascular health, reduce depression and boost immunity, but social science research has often linked casual encounters to feelings of sexual regret, low self-esteem and psychological distress, especially among women. Studies show that while men regret the sexual opportunities they missed, women often regret some of the casual sex they did have.

The solution

A Canadian study of 138 female and 62 male students who had casual sex found that men selected physical reasons for regret – such as their partner being insufficiently attractive. Women’s regrets focused on shame and self-blame. But the evidence as to whether casual sex, when done with protection against sexually transmitted diseases, is actually bad for anyone is unclear. The studies are overwhelmingly on heterosexual American university students and have varying definitions of hookups – from knowing someone for less than 24 hours, to sex in a “friends with benefits” relationship. Some show both men and women feel depressed, used and lonely after hookups; others find casual sex promotes more positive emotions than negative ones. In a study of 832 university students, only 26% of women compared with half of men felt positive after a hookup. Nearly half of women and 26% of men felt negatively about the experience.

Some factors are associated with an increased risk of feeling bad afterwards – these include having sex with someone you have known for less than 24 hours, drinking heavily or taking drugs beforehand, feeling you ought to rather than you want to, and hoping for a relationship afterwards. Interestingly, the Canadian study found that high-quality sex rarely led to regret.

Zhana Vrangalova, a professor of psychology at Cornell University, New York, who runs the Casual Sex Project – a website where people graphically share their encounters – argues that casual sex can improve wellbeing by increasing confidence, sexual pleasure and making people feel desirable. She points out in a TEDx talk that a study of 20,000 college students found that only 42% of women, compared with 78% of men, had an orgasm in their last hookup. This “pleasure gap” may partly explain the difference between men and women’s feelings about casual sex. But however pro-casual sex she is, Vrangalova warns that you shouldn’t hook-up if you care about seeing them again. Casual sex is not, she says, like doing the laundry.

Sexual health can be an uncomfortable or embarrassing topic to discuss for many people, and for patients with cancer and survivors it can feel even more awkward. Nevertheless, sex ranks among the top 5 unmet needs of survivors, and the good news is, proactive oncology practitioners can help fill that void.

Sixty percent of cancer survivors—9.3 million individuals in the United States alone—end up with long-term sexual problems, but fewer than 20% get professional help, according to Leslie R. Schover, PhD, founder of the digital health startup, Will2Love. Among the barriers she cited are overburdened oncology clinics, poor insurance coverage for services related to sexual health, and an overall lack of expertise on the part of providers, many of whom don’t know how to talk to patients about these issues.

And, oncologists and oncology nurses are well-positioned to open up that line of communication.

“At least take one sentence to bring up the topic of sexuality with a new patient to find out if it is a concern for that person,” Schover explained in a recent interview with Oncology Nursing News. “Then have someone ready to do the follow-up that is needed,” and have other patient resources, such as handouts and useful websites, on hand.

Sexual issues can affect every stage of the cancer journey. Schover, who hosted a recent webinar for practitioners on the topic, has been a pioneer in developing treatment for cancer-related problems with sexuality or fertility. After decades of research and clinical practice, she has witnessed firsthand how little training is available in the area of sexual health for healthcare professionals.

“Sex remains a low priority, with very little time devoted to managing sexual problems even in specialty residencies,” said Schover. “I submitted a grant four times before I retired, to provide an online interprofessional training program to encourage oncology teams to do a far better job of assessing and managing sexual problems. I could not get it funded.”

In her webinar, she offered tips for healthcare practitioners who want to learn more about how to address sexual health concerns with their patients, like using simple words that patients will understand and asking open-ended questions in order to engage patients and give them room to expand on their sex life.

Schover suggests posing a question such as: “This treatment will affect your sex life. Tell me a little about your sex life now.”

Sexual side effects after cancer treatment vary from person to person, and also from treatment to treatment. Common side effects for men and women include difficulty reaching climax, pain during sexual intercourse, lower sexual desire and feelings of being less attractive. Men specifically can experience erectile dysfunction and dry orgasm, while women may have vaginal dryness and/or tightness, as well as loss of erotic sensation such as on their breasts following breast cancer treatment.

Sexual dysfunction after cancer can often lead to depression and poor quality of life for both patients and their partners.

According to Schover, oncologists and oncology nurses should provide realistic expectations to patients when they are in the treatment decision-making process.

“Men with prostate cancer are told they are likely to have an 80% chance of having erections good enough for sex after cancer treatment,” Schover says. “But the truth is it’s more like 20 to 25% of men who will have erections like they had at baseline.”

To get more comfortable talking about sex with patients, Schover advises role-playing exercises with colleagues, friends, and family—acting as the healthcare professional and then the patient. When the process is finished, ask for feedback.

Brochures, books, websites and handouts are also good to have on hand for immediate guidance when patient questions do arise. But Schover is hoping for a bigger change rooted in multidisciplinary care and better patient–provider communication to find personalized treatments tailored to each individual’s concerns and needs.

Cancer treatment can impact hormonal cycles, nerves directing blood flow to the genitals, and the pelvic circulatory system itself, she explained. In addition, side effects like prolonged nausea, fatigue, and chronic pain also can disrupt a patient’s sex life.

“Simply to give medical solutions rarely resolves the problems because a person or couple needs to make changes in the sexual relationship to accommodate changes in physical function,” Schover stressed. “That kind of treatment is usually best coming from a trained mental health professional, especially if the couple has issues with communication or conflict.”

Schover wants to make sure that those resources are easily accessible to patients and survivors. Thus, she has created the startup, Will2Love, which offers information on the latest research and treatment, hosts webinars, and provides access to personalized services.

“Sexual health is a right,” concluded Schover, and both oncology professionals and patients need to be assertive in getting the conversation started.